Issue - Southern Medical Association

Case Report

Meningitis Due to an Unusual Human Pathogen: Streptococcus equi subspecies equi

Streptococcus equi subspecies equi is involved in human infection. We present a case of meningitis in a 75-year-old patient with a favorable outcome after ceftriaxone and dexamethasone therapy. To our knowledge, it is the first case reported in an adult. Key Points * Streptococcus equi subspecies equi human transmission is…

Case Report

Spinal Hydatid Disease, a Rare but Existent Pathological Entity: Case Report and Review of the Literature

Spinal hydatid disease is a not uncommon cause of spinal cord compression in endemic countries; however, involvement of the epidural space with sparing of the vertebral column is rare. Early diagnosis and surgical decompression with total removal of the hydatid lesion, when possible, is generally considered the standard of care…

Expired CME Article

Improving Antihypertensive Therapy in Patients with Diabetic Nephropathy

Nearly all patients with diabetic nephropathy have comorbid hypertension, which greatly elevates the risk for cardiovascular events. As patients are surviving longer, their risk of progressing to end-stage renal disease is increasing, particularly in patients with type 2 diabetes. Prevention of cardiovascular and renal events in this population requires diligent…

Case Report

Collision Tumor: Invasive Ductal Carcinoma in Association with Mucosa-associated Lymphoid Tissue (MALT) Lymphoma in the Same Breast

Synchronous occurrence of multiple neoplastic processes is uncommon and the relationship between breast cancer with lymphoproliferative diseases is unusual as well. Furthermore, breast involvement by malignant lymphoma is a rare event and primary breast mucosa-associated lymphoid tissue (MALT) lymphoma is even rarer. We report a patient with synchronous occurrence of…

Original Article

Lead and Copper in Drinking Water Fountains – Information for Physicians

Background: Lead and copper are potentially toxic metals. The objective of our work was to test the water from the drinking fountains of a large public access office complex in southwest Houston, Texas, for the presence of lead, copper, and microbiologic contamination. The data for the water fountains were compared…

Original Article

Medical Coverage of High School Athletics in North Carolina

Background: A significant percentage of high school students participate in athletics, and of those participating, at least one third will experience a sport-related injury. Despite the high risk of injury, there are few guidelines on what type of medical coverage should be provided for high school athletics. Although vague recommendations…

Case Report

Transient Synovitis of the Hip in an Adult

Transient synovitis of the hip is an acute and self-limited disease commonly seen in children. It is the most common cause of acute hip pain in children ages 3 to 10. It is not considered a disease of adults. It usually only affects one hip. The child may complain of…

Case Report

Localized Mycobacterium avium Complex Infection of Vertebral and Paravertebral Structures in an HIV Patient on Highly Active Antiretroviral Therapy

Before the introduction of highly active antiretroviral therapy (HAART) Mycobacterium avium complex (MAC) disease was the most common bacterial infection in patients with acquired immune deficiency syndrome (AIDS) in developed countries.1 Effective antiviral therapy against HIV has allowed for control of viral replication, improvement in immune function, and a significant…

Case Report

Idiopathic Hypereosinophilic Syndrome: A Rare but Fatal Condition Presenting with Common Symptoms

Introduction: Idiopathic hypereosinophilic syndrome (IHES) is a leukoproliferative disorder characterized by cytokine-induced overproduction of eosinophils with resultant multiorgan infiltration and damage. The diagnostic criteria includes evidence of end organ damage, exclusion of all other causes of eosinophilia and sustained absolute eosinophil count (AEC) > 1,500 cells/mcl for at least 6…

Case Report

Metaplastic Breast Carcinoma with Osseous Differentiation: A Case Report

Metaplastic breast carcinoma is a rare entity with the distinguishing feature of having epithelial and mesenchymal tissue types incorporated within one tumor. This is a case report of a patient found to have a rare metaplastic breast carcinoma with prominent osseous differentiation. Radiologic and pathologic correlation is provided. Key Points…

Case Report

Elevated CA 19-9 Levels in a Patient with Mirizzi Syndrome: Case Report

CA 19-9 is a marker of malignancy of the pancreas and biliary tract. We report the case of a patient who had significantly elevated serum CA 19-9 levels and imaging studies suggestive of malignancy. On laparotomy, the patient was found to have Mirizzi syndrome, an uncommon cause of biliary obstruction…

Original Article

Seatbelt Law Enforcement and Motor Vehicle Crash Fatalities Among Blacks and Whites in Louisiana and Mississippi

Background: Seatbelt laws save lives. Primary enforcement (allowing citations solely for seatbelt nonuse) is a more effective means of saving lives, yet seven southern states have no primary laws, due in part to concern about racial profiling. Methods: Non-Hispanic, black:white (B:W), occupant motor vehicle crash mortality rate ratios (MRRs) were…

Original Article

Cost-effectiveness Strategies to Treat Osteoporosis in Elderly Women

Background: Comparing the cost-effectiveness of various antiosteoporotic drugs has not been defined. Methods: We determined the cost-effectiveness of calcitonin, raloxifene, bisphosphates and PTH in a base-case cohort of women aged 65 or older with osteoporosis. After bone densitometry, women were stratified into groups of treatment or no treatment. Our outcome…

Case Report

Active Pulmonary Tuberculosis with Vertebra and Rib Involvement: Case Report

Multifocal skeletal tuberculosis is defined as osteoarticular lesions that occur simultaneously at two or more locations and is generally associated with disseminated disease. Although involvement of bones accounts for 1 to 5% of all tuberculosis cases, multifocal involvement of the skeleton is extremely rare. We present a case of active…

Case Report

A Rare Cause of Hemoptysis: Factitious Disorder

Hemoptysis is an important symptom that requires broad evaluation, including invasive procedures. Nevertheless, in a considerable number of patients, the cause of hemoptysis may not be adequately determined despite extensive investigations. Factitious hemoptysis is a manifiestation of Munchausen syndrome that describes a group of patients who intentionally produce or feign…

Editorial

If It Isn’t Something, It’s Something Else …

Disseminated disease due to nontuberculous mycobacteria (NTM) is among the most severe infections in persons with advanced HIV infection. The overwhelming majority (>90%) of these infections are caused by Mycobacterium avium complex (MAC).1–6 Disseminated disease due to MAC occurs only in persons who are severely immunocompromised with an average CD4+…

Editorial

Is Mouse Mammary Tumor Virus an Etiologic Agent of Human Breast Cancer and Lymphoma?

In this issue of the Journal, Quilon et al present a patient with synchronous invasive breast cancer and low-grade lymphoma. There was no evidence of lymphoma outside the breast, and the two neoplasms demonstrated collision histology. The question is whether their case simply represents a chance unusual occurrence, whether the…

Editorial

Skeletal Health Prognostications

The National Health and Nutrition Examination Survey (NHANES) is an ongoing cross-sectional population survey conducted by the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention (CDC). The objective of NHANES is to assess the health and nutrition of adults and children throughout…

Editorial

Spinal Hydatid Disease

As the title of the article by Sapkas et al indicates, spinal hydatid disease is rare and very few physicians will encounter this condition in North America. However, two strains of Echinococcus granulosus are endemic in animals in North America. The cervid strain is prevalent in the holarctic zones of…

Editorial

Tumor Markers: An Important Adjunct to Clinical Practice

The authors of the article, “Elevated CA 19-9 Levels in a Patient with Mirizzi Syndrome: Case Report”1 provide a unique scenario in which a person presents with an elevated serum carbohydrate antigen 19-9 (CA 19-9). The initial workup involved looking for typical causes such as biliary and ampullary carcinoma, but…

Errata

Erratum

Kasasbeh E, Chi DS, Krishnaswamy G. Inflammatory aspects of sleep apnea and their cardiovascular consequences. South Med J 2006;99:58–67. The article incorrectly stated that the authors had no financial disclosures to declare. Dr. Krishnaswamy received Grants/Research from NIH, NHLBI, NIAID, Pfizer, Merck, and GlaxoSmithKline. Drs. Kasasbeh and Chi have no…

Expired CME Article

CME Questions: Improving Antihypertensive Therapy in Patients with Diabetic Nephropathy

Expired CME Article Questions: Improving Antihypertensive Therapy in Patients with Diabetic Nephropathy

Expired CME Credit Submission and Evaluation Form

CME Credit – February 2006 CME Topic: Improving Antihypertensive Therapy in Patients with Diabetic Nephropathy

Expired CME Credit Submission and Evaluation Form – Improving Antihypertensive Therapy in Patients with Diabetic Nephropathy

Medical Webwatch

Medical Webwatch

Treatment Improvement Protocols (TIPs) http://www.kap.samhsa.gov/products/manuals/tips/index.htm are provided by the Knowledge Application Program (KAP) of the Substance Abuse for Mental Health Services Administration (SAMHSA). They are a series of best-practice guidelines for the treatment of substance abuse, and can be explored either by topic or in numerical order. Included in the…

Acknowledgment

Patient’s Page

February is National Heart Month Heart Facts: According to the Centers for Disease Control, more than 927,000 Americans die from heart disease each year, and over 70 million Americans (one quarter of the population) have some form of cardiovascular disease (high blood pressure, coronary heart disease, and/or stroke). What are…

SMA Centennial

Penicillin Is 65 Years Old!

The discovery of penicillin marked a turning point in history and dramatically changed the impact of medicine. It is hard to comprehend now the fear that arose from even a minor infection, as treatment often required the lancing of swollen glands and sometimes amputation, in an attempt to save the…